A part of the job the dentist may not have considered when opening a dental practice is dealing with insurance companies. As a matter of fact, it is one of the particularly stressful things the office deals with; but it is so very necessary. Dentists are in the business to make money and insurance companies want to make money, as well. As a result, they try to keep fees as low as possible. The less they have to pay the dental practice, the more money they make. Dentists need to learn to counter-offer to ensure they make the most money possible to cover the expenses of the business and make a good living.
There are classes available to learn to be a knowledgeable PPO fee negotiator, or you may decide to hire a negotiator. To prepare for future earning capacity, it may be wise to hire a professional negotiator. Negotiators know how to compare different offers for the same patients and these offers can be considered accordingly. Someone who has ongoing experience with insurance companies is important to give your dental practice guidance. A negotiator will have the background knowledge to be able to identify areas of improvement for your practice and to work with insurance providers to get better rates.
How to Choose the Right Negotiator for Your Practice
The negotiating professional you hire should know and understand insurance companies well. A clear understanding of the boundaries the insurance companies work with will benefit the dentist. They must demonstrate a professional, knowledgeable manner of negotiating without being rude or overpowering. Claims and issues which tend to go along with them should not even be mentioned, as insurance company negotiators have nothing to do with the claims process. Your negotiator should always present your practice in a positive light for future successful negotiations.
Negotiators, unlike dentists, communicate with the same insurance representatives each time. They often contact them directly and become well acquainted. As a result, the insurance representatives get to know your negotiator and how well they understand the industry. Don’t let your dental office get included on a “red flag list” during negotiations based on how your company is represented. Your dental clients will benefit from strong and positive negotiating relationships.
The negotiator you choose should be persistent with following up with companies and making sure your paperwork is being processed in a timely manner. They should be in contact with your insurance company on a regular basis to get the best reimbursement rates. Choose a negotiator with a top reputation with other dental practices in your area. If they are having great success for other practices, chances are good they will work just as diligently for you. You want to be represented professionally when working with insurance providers. Hire a negotiator who realizes they not only represent themselves, but your practice as well. Quality PPO fee negotiators specialize in strategy and data computation to get the best results.
Educating You and Your Team
Dental assistants are often the eyes and ears of the dental office. They are very important for the success of clinical record keeping and for success before, during and after any procedure. The dental assistant:
- Helps complete patient information forms
- Takes and records vital signs
- Charts and documents patient findings from the dental exam
- Processes dental radiographs
- Processes dental photographs
- Organizes patient records
- Prepares for each patient treatment
In order to qualify for the presentation of a case, the dental assistant choses the corresponding CDT codes so the treatment plan includes all procedures completed and to be completed in future appointments. Dental assistants must be involved in this process to learn to properly get a claim paid. Proper narratives are required in the dental notes from each procedure, along with proper radiographs, periodontal charting and other diagnostic tools. Dedicated time to train dental staff must be set aside at regular intervals, as it will have a positive effect on team growth, care of patients and team relationships.
To summarize, whether you make the decision to handle re-negotiations on your own or decide to hire a professional to negotiate for you, foster realistic expectations. Some insurance companies will not negotiate and some will. Just make sure to maximize your results by researching how each insurance company works. Whoever negotiates on your behalf is a representative of your dental practice. Your results depend upon them. Creating and maintaining a good reputation is key to receiving top dollar because you understand the industry and package negotiations to benefit you and the providers.
One of the trickiest parts of the negotiating process is comparing the final offers. Someone who stays up-to-date on the industry is very important when guiding your dental practice. At PPO Negotiation Solutions, not only have we made a company commitment to ourselves to do it right, but we have also made this commitment to our doctors and carriers. For more information on our services and finding out if they are a good fit for your dental practice, get your complimentary assessment or schedule your consultation today.